Prostate Cancer: Risk Factors, Symptoms & Treatment Options

Receiving a diagnosis of prostate cancer is a nightmare for most patients. After times of uncertainty, you finally know what it is, but for most diagnosed patients, it is just the beginning – of more uncertainty. After the diagnosis, you’ll get more and more tests, and if possible you’ve to start treatment immediately. Almost 200,000 American men get diagnosed with this type of cancer each year, and it affects 1 in 9 men during their life. Even though there are many effective treatments for this form, approximately 33,000 men die annually. This is why it’s so important to know how to recognize this type of cancer in its early stages.

Diagram of illustration of prostate cancer

What is Prostate Cancer?

Prostate cancer is a form that occurs – or starts – in the prostate. This is a small walnut-shaped gland in the male reproductive system. The prostate plays a big part in the male reproductive system, as it makes fluid that mixes with semen when ejaculation takes place. This fluid is how semen protects itself and stays healthy until conception. Most cases are adenocarcinomas – better known as cancerous tumors. In rare cases it can also be:

  • Small cell carcinoma
  • Transitional cell carcinoma
  • Neuroendocrine tumor
  • Sarcoma

Causes & Risk Factors of Prostate Cancer

Medical experts still do not know the exact reason for cells in the prostate to become cancerous. Currently, they believe it is mainly due to genetics. For instance, if an immediate family member like your father, brother, or son has been diagnosed with prostate cancer, your odds of getting it are 2 to 3 times higher. Hereditary gene mutations like BRCA 1 & 2 can also contribute to the development of this cancer.

The biggest risk factor for prostate cancer is age. Men older than 55 are most at risk. According to the American Cancer Society, the average age for discovering this form of cancer in men is 66 years old. In addition, is ethnicity also a big risk factor. African-American men, for example, are most at risk of getting and dying from this form of cancer. Other risk factors include:

  • Hereditary
  • Obesity
  • Smoking


When prostate cancer is diagnosed, the professional healthcare provider, often a urologist or oncologist, also tells in which stage the cancer is. This is determined via the TNM staging system, PSA levels, and a Gleason score. There are 4 stages; the first one means the tumor is slowly progressing, the tumor cannot be felt, and the malignant cells almost look healthy. The second stage means the tumor is only found in the prostate gland. Although the cancer is small, all the levels are higher than in the first stage and there is a risk of growing & spreading.

infographic about psa test

In the third stage, the cancer is growing and is possibly spread through the outer layer of the prostate to nearby lymph nodes, tissue, or organs, such as the bladder or rectum. In the fourth – and last-stage, cancer has spread to more distant lymph nodes, tissue, and organs, such as the lungs, brain, and liver.

Prostate-specific Antigen Blood Test (PSA)

A PSA-level test is one of the first tests a professional healthcare provider will do to see if you’ve prostate cancer. Prostate-specific antigen is a protein made in the prostate gland. This test is taken to see if your prostate-specific antigen, or PSA, levels are elevated. If this is the case, you might have prostate cancer. Healthy PSA levels depend on a person’s age; normal PSA levels of a man should be 4.0 ng/mL – or lower. Note: elevated PSA levels may also indicate prostatitis, or an enlarged prostate, or can be elevated because of recent sexual intercourse or other vigorous exercises. For example cycling.

Gleason score

The most used way to assess how aggressive the cancer cells are is the Gleason score. The range starts from 2 (not aggressive cancer) to 10 (highly aggressive cancer). This score is used to assess cancerous (prostate) biopsies, so when a biopsy is done, researchers will examine it, and scale it from 6 (low-grade prostate cancer), to 7 (medium-grade prostate cancer), to 8-10 (high-grade prostate cancer).

A major complication of (untreated) prostate cancer is metastasized cancer. This means that the cancer is spread to (nearby) body tissue, lymph nodules, and/or organs. Once the cancer is in vital organs and does damage, the organ can stop working which can lead to death. Other complications are incontinence and erectile dysfunction. This is why it’s important to check as much as possible and recognize its warning signs.

Symptoms of prostate cancer

Symptoms of Prostate Cancer

Unfortunately, there aren’t any early symptoms of prostate cancer. This means that when you experience symptoms, cancer has probably progressed. Symptoms of prostate cancer include:

  • Frequent (& urgent) need to urinate – at night
  • Weak urine flow or flow that stops and starts
  • Painful urination
  • Fecal incontinence
  • Painful ejaculations
  • Erectile dysfunction
  • Blood in urine and/or semen
  • Lower back pain
  • Hip pain
  • Chest pain
  • Leg and/or feet numbness
  • Unintended weight loss
  • Bone pain

Treatment Options

Before a professional healthcare provider can diagnose someone, they have to do several tests and exams. Screening tests for prostate cancer include a rectal exam, to examine the prostate gland, a prostate-specific antigen (PSA) blood test, elevated levels that may indicate cancer, and a biopsy, to examine the prostate for cancerous cells.

If the diagnosis of prostate cancer has been made, not all men need to be treated, as their cancer progresses slowly and doesn’t spread. This group of men will be under active surveillance, which means they will be re-examined every 1 – 3 years to see how the cancer has grown and whether treatments should take place at that time. Treatment options for prostate cancer include:

  • Brachytherapy
  • External beam radiation therapy
  • Systemic therapy, like chemotherapy & immunotherapy
  • Focal therapy
  • Prostatectomy

There are so many ways to treat cancer these days, the above-mentioned options are just a few examples. Sometimes they are combined, but it can also happen that these treatments do not help (anymore), so other options should be considered. That’s why it’s essential to do your own extensive online research and stay up to date about new treatments. Have you already been diagnosed with prostate cancer but aren’t satisfied with your treatment plan? Getting a second opinion in another hospital or oncology center is always smart. Continue your search for more information about prostate cancer, PSA levels by age charts, and cancer treatment options here:

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